Provider Demographics
NPI:1902008626
Name:CARNEY, MARY FRANCES (RN CS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:CARNEY
Suffix:
Gender:F
Credentials:RN CS
Other - Prefix:
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Mailing Address - Street 1:231 SAVIN HILL AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-1021
Mailing Address - Country:US
Mailing Address - Phone:617-825-8428
Mailing Address - Fax:617-265-6121
Practice Address - Street 1:71 ADAMS ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3431
Practice Address - Country:US
Practice Address - Phone:617-438-4358
Practice Address - Fax:617-265-6121
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA124732364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPN0816OtherBLUE CROSS BLUE SHIELD
MAPN0816OtherBLUE CROSS BLUE SHIELD